For a study, researchers focused on identifying risk factors for continued worsening of central visual function in eyes with advanced glaucoma. Patients with advanced glaucoma who have well-controlled intraocular pressure (IOP), a mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24-2 program of ≤–20 dB, and a best-corrected visual acuity (BCVA) of 20/40 were included. For a period of five years, the HFA 10-2 test and BCVA examination were conducted every six months, and the HFA 24-2 test was performed every twelve months. To identify risk variables for worsening of HFA 10-2 and 24-2 findings, as well as BCVA, the Cox proportional hazards model was applied. Deterioration of HFA 10-2 results was defined as the presence of the same ≥3 points with a negative total deviation slope of ≤–1 dB/year at P<0.01 on ≥3 consecutive tests, deterioration of HFA 24-2 results by an increase of ≥2 in the Advanced Glaucoma Intervention Study score on ≥2 consecutive tests and deterioration of BCVA by an increase of ≥0.2 logarithms of the minimum angle of resolution (logMAR) on ≥2 consecutive tests.
A total of 175 eyes from 175 individuals were enrolled in the study (mean age, 64.1; mean baseline IOP, 13.2 mmHg; mean BCVA, 0.02 logMAR; and mean HFA 24-2 and 10-2 MD, –25.9 and -22.9 dB, respectively). At 5 years, the probabilities of worsening in HFA 10-2 and 24-2 findings, as well as BCVA, were 0.269±0.043 (standard error), 0.173±0.031, and 0.194±0.033, respectively. Lower baseline BCVA (P=0.012) was strongly linked with subsequent worsening of HFA 10-2 findings. Better HFA 24-2 MD (P<0.001) and use of systemic antihypertensive agents (P=0.009) were significantly associated with further deterioration of HFA 24-2 results, and a greater β-peripapillary atrophy area-to-disc area ratio (P<0.001), use of systemic antihypertensive agents (P=0.025), and lower BCVA (P=0.042) were significantly associated with further deterioration of BCVA, β-peripapillary atrophy area-to-disc area ratio, and use of systemic antihypertensive medications were significant predictive indicators for continued loss of central visual function in advanced glaucoma eyes with well-controlled IOP.
Reference:www.aaojournal.org/article/S0161-6420(21)00922-2/fulltext
